Mesothelioma CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2], Sujit Routray, M.D. [3]

Chest CT scan may be diagnostic of mesothelioma. CT is the most commonly used modality for the assessment of mesothelioma and is able to stage the disease accurately in majority of the patients.^[1]

• Chest CT scan is the most commonly used modality for the assessment of mesothelioma and is able to stage the disease accurately in majority of the patients.^[1]
• The appearance is that of a soft tissue attenuation nodular mass which spreads along pleural surfaces including into pleural fissures and often creating a pleural rind.
• Calcification is seen in 20% of cases which usually represents engulfed calcified pleural plaques rather than true tumor calcification.
• Sarcomatoid variants may demonstrate osteosarcoma or chondrosarcomatous components which may also be calcified.
• An rare variant is the solitary mediastinal malignant mesothelioma which has appearance of a solitary fibrous tumor of the pleura.^[1]
• Mesothelioma may be associated with direct invasion of adjacent structures (chest wall, diaphragm, and mediastinal content) but also frequently metastasis to the contralateral lung and local nodes.
• Chest wall invasion is suggested by direct extension in bone or muscle identified on CT scan.
• Presence of a pericardial effusion suggests transpericardial extension.^[1]

• 
  _{CT scan of chest demonstrating a circumferential nodular soft tissue encasement of the left lung. There is volume loss with elevation of the hemidiaphragm and shift of the mediastinum. A number of enlarged mediastinal nodes are noted.^[2]}

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